Abstract: An exemplary method includes delivering a cardiac pacing therapy that includes an atrio-ventricular delay and an interventricular delay, providing a paced propagation delay associated with delivery of a stimulus to a ventricle, delivering a stimulus to the ventricle, sensing an event in the other ventricle caused by the stimulus, determining an interventricular conduction delay value based on the delivering and the sensing, determining a interventricular delay (?Sur) based on the interventricular conduction delay and the paced propagation delay and determining an atrio-ventricular delay based at least in part on the interventricular delay (?Sur). Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes performing a ventricular capture assessment, determining a ventricular paced propagation delay (PPD) and/or an interventricular conduction delay (IVCD) using information acquired during the ventricular capture assessment and optimizing at least an interventricular delay (VV) based at least in part on the ventricular paced propagation delay (PPD) and/or the interventricular conduction delay (IVCD). Another exemplary method includes performing an atrial capture assessment, determining an atrial evoked response width (?A) and one or more atrio-ventricular intervals (AR) using information acquired during the atrial capture assessment and optimizing an atrio-ventricular (PV or AV) delay based at least in part on the atrial evoked response width (?A) and the one or more atrio-ventricular intervals (AR). Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Implantable systems, and methods for use therein, perform at least one of a cardiac assessment and an autonomic assessment. Short-term fluctuations in PR intervals, that follow the premature contractions in the ventricles, are monitored. At least one of a cardiac assessment and an autonomic assessment is performed based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles. This can include assessing a patient's risk of sudden cardiac death (SCD), assessing a patient's autonomic tone and/or detecting myocardial ischemic events based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles.

Abstract: An exemplary implantable device includes control logic to determine a base state atrio-ventricular delay (e.g., PV base or AV base) based on width of an atrial event (e.g., ?P or ?A) as measured during a patient base state and based on a value of a parameter ? that depends on the atrial event and control logic to determine an active state atrio-ventricular delay (e.g., PV active or AV active) based at least in part on a base state interval (e.g., DD base or AD base) measured during a patient base state and an active state interval (e.g., DD active or AD active) measured during a patient active state where such intervals extend from the end of a respective atrial event to the beginning of a respective ventricular QRS complex or a point within a respective ventricular QRS complex. Various other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An assembly for the delivery of a cardiac surgical device is disclosed herein. In one embodiment, the assembly includes a slittable delivery device and a bypass assembly. The slittable delivery device may include a hub, a shaft integrated into the hub and forming at least a segment of the circumferential surface of the hub, and a hemostasis valve contained substantially within the hub. The bypass assembly may include a cap and a valve bypass tool. The cap may be on a proximal end of the hub and may include an opening in the cap extending radially outward from a point near a radial center of the cap through a circumferential edge of the cap. The valve bypass tool may be operably coupled to the cap and may include a longitudinally extending open channel.

Abstract: Disclosed herein is a slittable delivery device for the delivery of a cardiac surgical device. The delivery device includes a hub and a shaft integrated into the hub. The shaft forms at least a segment of the circumferential surface of the hub. The delivery device may also include a hemostasis valve contained substantially within the hub and a cap on a proximal end of the hub. The cap may include an opening in the cap extending radially outward from a point near a radial center of the cap through a circumferential edge of the cap.

Abstract: Implantable systems, and methods for use therewith, are provided for monitoring myocardial stability based on a signal that is indicative of functioning of a patient's heart for a plurality of consecutive beats. Sample data is obtained that is representative of functioning of a patient's heart for a plurality of consecutive beats, wherein each beat has a corresponding cycle length that may differ from cycle lengths of other beats. Such sample data is adjusted so that cycle lengths of consecutive beats represented in the adjusted sample data are substantially equal. Myocardial stability is then monitored based on the adjusted sample data. Where the obtained sample data is representative of electrical functioning of the patient's heart, electrical stability can be monitored, e.g., by monitoring for electrical alternations. Where the obtained sample data is representative of mechanical functioning of the patient's heart, mechanical stability can be monitored, e.g., by monitoring for mechanical alternans.

Abstract: A connector assembly includes a conductive collet spring with an annular base and integral circumferentially spaced cantilevered generally parallel arms terminating at tip members diametrically spaced closer than the diameter of the base. A conductive housing overlying and electrically and mechanically engaged with the collet spring engageably receives the electrical terminal of a medical stimulating device and includes a distal mounting flange. A non-conductive barrel is fittingly attached to the distal mounting flange of the housing and has an inner bore for receiving a medical electrical lead. A non-conductive header encapsulates the connector assembly, is mounted on the casing, and has a header bore aligned with the inner bore for receiving the medical electrical lead which, when inserted and sufficiently advanced through the header bore, the inner bore, and the annular base, the tip members firmly engage the proximal terminal pin thereof.

Abstract: A method and device for collecting and storing electrophysiological data is presented. The method comprises: (a) sensing electrophysiological data from a patient; (b) classifying data intervals as either a critical interval or a non-critical interval; (c) identifying an episode; and (d) directing storage of the data representing the episode in the memory unit, wherein the data representing the episode is stored at varying sampling frequencies depending on the classification of the data interval. The device comprises a sense circuit, a processor, and a memory unit, wherein the processor is adapted to perform the above-stated method.

Abstract: A method for manufacturing an electrolytic capacitor with improved deformation qualities includes impregnating an electrolytic capacitor with a first electrolyte, aging the electrolytic capacitor after impregnating and reimpregnating the electrolytic capacitor with a second electrolyte. The water content of the second electrolyte is lower than the water content of the first electrolyte. The second electrolyte may also have a lower viscosity and a higher conductivity than the first electrolyte.

Abstract: A method for diagnosing an implantable cardiac device including a plurality of implanted leads may include: monitoring a plurality of parameters associated with the plurality of implanted leads; detecting a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnosing a problem with the implantable cardiac device based on the detected change and the evaluation. A system for diagnosing an implantable cardiac device including a plurality of implanted leads may include an implantable pacing device and a processor. The processor may be configured to: monitor a plurality of parameters associated with the plurality of implanted leads; detect a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnose a problem with the implantable cardiac device based on the detected change and the evaluation.

Abstract: A feedthrough assembly for use with implantable medical devices having a shield structure, the feedthrough assembly engaging with the remainder of the associated implantable medical device to form a seal with the medical device to inhibit unwanted gas, liquid, or solid exchange into or from the device. One or more feedthrough wires extend through the feedthrough assembly to facilitate transceiving of the electrical signals with one or more implantable patient leads. The feedthrough assembly is connected to a mechanical support which houses one or more filtering capacitors that are configured to filter and remove undesired frequencies from the electrical signals received via the feedthrough wires before the signals reach the electrical circuitry inside the implantable medical device.

Abstract: Methods, systems and devices are provided for monitoring respiratory disorders based on monitored factors of a photoplethysmography (PPG) signal that is representative of peripheral blood volume. The monitored factors can be respiratory effort as well as respiratory rate and/or blood oxygen saturation level. The systems and devices may or may not be implanted in a patient.

Abstract: Methods and systems are presented for using an ICD to detect myocardial ischemia. One such method includes sensing via an implantable cardiac-rhythm-management device (ICRMD) a signal indicative of cardiac pressure; determining via a processor associated with the ICRMD, a derivative signal that is a first derivative of the sensed signal; measuring via the processor, a maximum positive value of the derivative signal; measuring via the processor, a maximum negative value of the derivative signal; and indicating via the processor, an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.

Abstract: A lead implantation system with an introducer, a lead configured to engage with the introducer such that the introducer can convey the lead to a desired internal target location, and at least one sensor. The sensor is adapted to generate an indicator of desired engagement of the system with the desired target tissue location prior to engagement of the lead with the target tissue. Also a method of implanting an implantable patient lead including advancing a lead implantation assembly towards a desired target location along an introduction axis and monitoring at least one indicator of lead implantation assembly position along the lead introduction axis. At least one indicator can be generated by the lead implantation assembly. Advancing of the lead introduction assembly can be halted when the monitoring indicates contact with the desired target tissue. The patient lead can then be advanced towards the target tissue and fixed to the target tissue.

Abstract: A method of predicting a patient's response to multi-chamber pacing by implanting at least three sensing electrodes, measuring across at least two different impedance vectors of the heart via the three electrodes to obtain at least two impedance signals, and evaluating the at least two impedance signals for indications of contractile dysynchrony. Contractile dysynchrony indicates that the patient is likely to have a positive response to multi-chamber pacing. Also an implantable cardiac stimulation device with an implantable housing, a stimulation pulse generator positioned within the housing, at least two implantable leads, and a controller communicating with the pulse generator to induce the generator to deliver therapeutic stimulation to a patient's heart. The leads are arranged to measure a physiological parameter along at least two different spatial orientations.

Abstract: Systems and methods are provided for adjusting atrioventricular timing of a cardiac resynchronization therapy device, based upon multi-modal sensory data. In one particular embodiment, one or more acoustic signals are processed and categorized into certain cardiac-related mechanical events. Impedance waveforms are obtained from implanted electrodes and analyzed to identify certain valvular events. The acoustic and impedance data is analyzed to optimize AV timing and improve cardiac performance.

Abstract: An implantable cardiac device to induce fibrillation in the heart of a patient to allow testing of the defibrillation capability of the device. The device induces fibrillation using a direct current across the heart. The shock to the heart may be applied in a method to minimize discomfort to the patient. The heart is monitored during application of the shock. The voltage of shock at the heart is gradually increased until fibrillation is induced. Once the fibrillation is detected the shock may be stopped. This results in a minimized voltage level and duration for the shock to the heart, thereby diminishing pain and discomfort to the patient.

Abstract: An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay parameter and an interventricular delay parameter, measuring an atrio-ventricular conduction delay, measuring an interventricular conduction delay, assessing heart failure and/or cardiac resynchronization therapy performance based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay and determining at least one of an atrio-ventricular delay parameter value and an interventricular delay parameter value based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay. Other exemplary technologies are also disclosed.

Abstract: Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (ZT) and cardiogenic impedance (ZC). In one example, the implantable device tracks the maximum time rate of change in cardiogenic impedance (i.e. max(dZC/dt)) to detect trends toward hypervolemic or hypovolemic states within the patient based on changes in heart contractility. The detection of these trends in combination with trends in thoracic impedance allows for a determination of whether the thoracic cavity of the patient is generally “too wet” or “too dry,” and thus allows for the titration of diuretics to avoid such extremes. In particular, a decrease in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too wet” (i.e. a fluid overload). Conversely, an increase in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too dry” (i.e. a fluid underload).